Melatonin is seen to have anti-cancer effects, as we saw in last week’s blog post.  In addition to those benefits, it may also have other effects which could be useful in palliative care of cancer patients, when there are no other treatment options. 

Let’s look at a randomized trial investigating melatonin for palliative care and see what was found.

Study design

The clinical study [1] investigated whether melatonin may help in palliative care, by studying 1,440 patients.  These all had untreatable advanced solid tumors and had not responded to previous standard anti-cancer therapies.  The patients were randomized according to their tumor type into two groups.  One group received standard supportive care alone (SC), and the second group received standard supportive care plus melatonin (20mg per night) (SC+Mel).   The melatonin treatment was continued for at least 2 months.   The supportive care included use of opioids and anti-inflammatory non-steroidal drugs.

The types of cancers included lung, colorectal, gastric, pancreatic, liver, breast, prostate, ovarian, renal, bladder, testis, melanoma, soft tissue sarcoma, head and neck, and glioblastoma.

The goal of the study was not curative but to see if quality of life could be improved with less stress and symptoms.

Results

Disease response

Complete or partial response – No complete or partial response was seen in the supportive care (SC) group – as expected.  In the supportive care plus melatonin (SC+Mel), 17 patients out of 722 did show a partial response. While this is only 2% of the patients, the result was statistically significant (P<0.05).

Stable disease – The percentage of patients with stable disease was also significantly better (higher) in those who received melatonin compared to SC (171/772 for SC+ Mel vs 54/718 for SC, P<0.001).

1-year survival – The graph at the top of this blog post shows the percentage 1-year survival of SC vs SC+Mel. The melatonin treatment resulted in significantly higher rates of 1-year survival than SC (P<0.005).

But at this stage of your life, the quality of life is often more important than just survival, so let’s look further into the results. 

Quality of life

Symptom reduction – The study compared symptoms between the two groups. They looked at cachexia, asthenia, anorexia, depressive symptoms, anemia, thrombocytopenia and lymphocytopenia.  (If you are unfamiliar with any of these terms, please use the ‘dictionary of cancer terms’ search box in the sidebar to help you).

Melatonin was seen to statistically significantly reduce all these symptoms apart from anemia. (The anemia rates were still slightly better with melatonin than SC, but not statistically significant.) Examples of the differences included:

  • 26% of SC patients had cachexia whereas only 5% of melatonin patients did (P<0.001).
  • 68% of SC patients had lymphocytopenia whereas only 28% of melatonin patients did (P<0.001).
  • 23% of SC patients had depressive symptoms whereas only 13% of melatonin patients did (P<0.01)

Best responders – The greatest benefit in terms of disease stabilization was seen in the following cancers: non-small cell lung cancer, colorectal cancer, gastric cancer, hepatocarcinoma (liver) cancer and prostate cancer.  

Toxicity – No melatonin related toxicity was seen, and in fact, most patients taking melatonin experienced an anti-anxiety effect.

Conclusions regarding melatonin for palliative care

This study was conducted on a large number of patients, with different types of cancers.   The results confirm the results of previous studies, showing that melatonin is efficacious in the palliative treatment of cancers, improving quality of life, stabilizing the disease, as well as increasing survival.  

We will continue next week with more information about melatonin, so if you are interested, sign up to receive our blog posts (only twice a week) by email. The sign-up is on the side bar – just enter your email address.  Feel free to print off this blog post and take it to your healthcare provider if you are interested in using melatonin.  

 

[1]. Lissoni, P. (2002). Is there a role for melatonin in supportive care?  Support Care Cancer, 10, 110-116.

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